For 54 years the annual Montagna Symposium on the Biology of Skin has fulfilled its mission to gather leading cutaneous biology scientists and dermatologists in a uniquely designed conference to discuss new findings, techniques and goals in skin biology, to foster collaborations among disciplines that enrich the scientific and clinical specialty, and to encourage young investigators. Each year the Symposium addresses a different specific topic in skin biology encompassing the major areas of active skin research and the unanswered questions about causes and cures for skin diseases. The central support of this meeting is a multi-year conference grant from the NIH. This provides the basis for inviting Program Chairs and scientific presenters and for soliciting support anew each year from corporate and foundation donations. These, along with registration fees, offset the balance of meeting production costs. The Symposium attracted 136 'attendees in the fall of 2004, including 17 core speakers, 29 short talk presenters and 33 poster presenters. This number of participants fosters the informal interactions that are the essence of the meeting. The interactions are among participants in basic research, clinical research and patient care, pharmaceutical research, and foundation research;between trainees and established scientists;and between dermatology faculty and those from other departments/fields. Participation of young scientists is encouraged by poster presentation opportunities and by travel awards. The meeting format also includes a clinician/scientist session designed to identify unanswered questions, strategies to overcome roadblocks, and opportunities for translation to new treatments. Lastly, the Symposium communicates its presentations by website and publication of papers presented. This meeting uniquely fulfills the NIH goal to advance scientific progress in understanding of the basic structure and molecular regulation of human biology and disease. Central focus on the skin offers unique opportunities for multidisciplinary research of clinical relevance, and discoveries made in the skin have enriched knowledge and treatment options in other organs beyond the skin. The complex nature of disease makes it essential that there are comprehensive approaches recognizing the separate but interacting elements tying molecular events to the pathophysiological, tissue and clinical presentations.